Division of Pediatric Allergy and Asthma Unit, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
Turk J Med Sci. 2019 Aug 8;49(4):963-984. doi: 10.3906/sag-1810-105.
Atopic dermatitis (AD) is the most common chronic inflammatory skin disorder of childhood. Underlying factors that contribute to AD are impaired epithelial barrier, alterations in the lipid composition of the skin, immunological imbalance including increased Th2/Th1 ratio, proinflammatory cytokines, decreased T regulatory cells, genetic mutations, and epigenetic alterations. Atopic dermatitis is a multifactorial disease with a particularly complicated pathophysiology. Discoveries to date may be considered the tip of the iceberg, and the increasing number of studies in this field indicate that there are many points to be elucidated in AD pathophysiology. In this review, we aimed to illustrate the current understanding of the underlying pathogenic mechanisms in AD, to evaluate available treatment options with a focus on recently discovered therapeutic agents, and to determine the personal, familial, and economic burdens of the disease, which are frequently neglected issues in AD. Currently available therapies only provide transient solutions and cannot fully cure the disease. However, advances in the understanding of the pathogenic mechanisms of the disease have led to the production of new treatment options, while ongoing drug trials also have had promising results.
特应性皮炎(AD)是儿童最常见的慢性炎症性皮肤病。导致 AD 的潜在因素包括上皮屏障受损、皮肤脂质组成改变、免疫失衡,包括 Th2/Th1 比值增加、促炎细胞因子增加、调节性 T 细胞减少、遗传突变和表观遗传改变。AD 是一种具有复杂病理生理学的多因素疾病。迄今为止的发现可能只是冰山一角,该领域越来越多的研究表明,AD 病理生理学还有许多方面需要阐明。在这篇综述中,我们旨在阐明 AD 潜在发病机制的现有认识,评估现有的治疗选择,重点关注最近发现的治疗药物,并确定疾病的个人、家族和经济负担,这些都是 AD 中经常被忽视的问题。目前可用的治疗方法只能提供暂时的解决方案,无法完全治愈疾病。然而,对疾病发病机制的认识的进步导致了新的治疗选择的产生,而正在进行的药物试验也取得了有希望的结果。